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. 2022 Dec 28;22(1):896.
doi: 10.1186/s12909-022-03965-9.

Development, outcome and costs of a simulation-based neurosurgery bootcamp at the national level

Saqib Kamran Bakhshi  1 , Rida Ahmad  2 , Asma Altaf Hussain Merchant  2 , Ali Aahil Noorali  2 , Komal Abdul Rahim  2   3 , Namra Qadeer Shaikh  2 , Noreen Afzal  2 , Maryam Pyar Ali Lakhdir  2   3 , Muhammad Shahzad Shamim  2 , Adil Hussain Haider  2
Affiliations

Development, outcome and costs of a simulation-based neurosurgery bootcamp at the national level

Saqib Kamran Bakhshi et al. BMC Med Educ. .

Abstract

Introduction: With a growing interest in simulation-based training to develop clinical proficiency, bootcamps have been utilized for imparting basic skills to medical trainees. While considerable research on the topic exists in high income countries, no such neurosurgical teaching standards have been employed in Low- and Middle-Income Countries.

Methods: We conducted a cross-sectional study to explore the effectiveness of first low-cost, multi-center regional neurosurgery bootcamp in South Asia. Twenty-two participants attended the bootcamp and practiced 12 hands-on skills over the course of 2 days. Burr-holes and craniotomies were done on 3D printed skulls. Lumbar drain insertion was practiced on a purpose-built lumbar puncture mannequin. For laminectomy, we used an in-house designed simulation. The modified Objective Structured Assessment of Technical Skills tool was utilized for skills Assessment. Feedback from faculty and residents was collected via a standard 5-point Likert scale.

Results: Only one participant (4.55%) had previously attended a neurosurgical skills workshop. Comparison of outcomes on 1st and 3rd attempts of cranial and spinal skills showed a significant improvement in all 14 domains assessed (p <0.05). Positive feedback was received ranging from 3.9 up to 4.8 on a 5-point Likert scale. Overall cost per participant culminated to $145, significantly lower than previously reported data.

Conclusion: Our findings report the effectiveness of sustainable, low-cost training models which can be easily reproduced elsewhere. These indigenously designed simulators can be modified for variable difficulty level and serve as an effective educational strategy in improving learners' skills, knowledge and confidence.

Keywords: Neurosurgery; Residency; Simulation-based training.

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Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Fig 1
Fig 1
Faculty teaching residents at the bootcamp
Fig 2
Fig 2
Spine surgery simulator. Part A shows the two components made of foam covered with rexine, which opens like a book. The lower part has space in the middle for spine model, and the upper part has a slit like opening depicting incision. Part B shows the widened opening by applying lumbar spine retractors for better exposure. The spine model is made of saw-bone material. Part C shows pictures taken under the microscope before and after laminectomy. Latex glove was used to simulate dura, and it was pasted on a 5cc plastic syringe with a window in middle. Suture is being applied using 6’0 Prolene under microscope as seen above. Each simulator had L1 to S1 spine model, and two residents worked on one model during the bootcamp.
Fig 3
Fig 3
Prior experience of residents in performing the four operating skills that were evaluated
Fig 4
Fig 4
Details of bootcamp cost
See this image and copyright information in PMC

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